颈内动脉严重狭窄或闭塞后颈总动脉与颈内动脉虹吸段血流频谱的改变  

The Blood Flow Changes of Common Carotid and Siphon Segment of Internal Carotid Artery with Severs Stenosis or Occlusion

作　　者：高山[1] 黄一宁[1] 汪波[1] 金征宇[2] 李敬府[3] 

机构地区：[1]中国医学科学院中国协和医科大学北京协和医院神经内科,100730 [2]中国医学科学院中国协和医科大学北京协和医院放射科,100730 [3]中国医学科学院中国协和医科大学北京协和医院超声科,100730

出　　处：《中国超声医学杂志》2000年第4期274-276,共3页Chinese Journal of Ultrasound in Medicine

摘　　要：目的 :分析颈内动脉严重狭窄或闭塞 (ICASO)后颈总动脉 (CCA)和颈内动脉虹吸段 (SIPHA)血流频谱的改变 ,提高经颅多普勒超声 (TCD)对 ICASO的检出率和准确性。方法 :ICASO患者 12 0例 ,全部经颈部血管彩超检查证实 ,其中 6 2例经脑血管造影 (DSA)进一步确诊。双侧病变 33例 ,单侧病变 87例 ,共有病变血管15 3条 (狭窄 94条 ,闭塞 5 9条 )。全部行 TCD检查。结果 :(1)狭窄或闭塞侧颈总动脉平均血流速度 (Vm)和收缩期血流速度 (Vs)较无病变侧明显降低 (P<0 .0 5 ) ;病变侧脉动指数 PI (2 .0± 0 .6 )较无病变侧 PI (1.6± 0 .5 )明显增高 ,尤其闭塞侧增高最明显 PI (2 .37± 0 .5 ) ,(P<0 .0 1) ,呈低血流高阻力频谱 ;(2 )狭窄侧虹吸部血流频谱的改变 :眼动脉发出之前局限性狭窄或闭塞者血流低平 ;狭窄自起始部开始至眼动脉发出之后闭塞者呈高阻力低血流同眼动脉的频谱 ;合并虹吸段狭窄时血流速度增高频谱紊乱。结论 :检查颈总动脉和虹吸段的血流能提高对颈内动脉严重狭窄或闭塞病变的检出率和准确性。Objective:The aim of this study was to analyze the blood flow frequency changes of common carotid artery(CCA)and siphon segment(SIPHA)of internal carotid artery(ICA)with severe stenosis or occlusion.Methods:All 120 patients was confirmed by Duplex and 62 patients by Duplex and digital subtraction angiography(DSA).TCD performed for all.Results:1.Common cardotid artery blood flow velocity ispilateral to stenosis or occlusion was reduced and pulsatility index(PI)was increased compared with contralateral.PI was significantly higher at occlusion side than that at stenosis( P <0 01).2 The blood flow frequency findings of siphon artery were three:1),Low flow velocity and resistance waveform were detected when occlusion or local stenosis occurred proximal to the origin of ophthalmic artery(OA).2).Low flow velocity and high resistance waveform were found when occlusion occurred distal to the origin of OA.3).High flow velocity was found in some patients accompany stenosis of the siphon.Conclusion:Examination of CCA and siphon arteries can increase diagnosis accuracy of severe ICA stenosis or occlusion.

关 键 词：颈内动脉闭塞 TCD 颈总动脉 血流频谱 

分 类 号：R445.1[医药卫生—影像医学与核医学]